Psychology of Addictive Behaviors © 2013 American Psychological Association

2013, Vol. 27, No. 4, 1110 –1121 0893-164X/13/$12.00 DOI: 10.1037/a0031173

White and Black Adolescent Females Differ in Profiles and Longitudinal

Patterns of Alcohol, Cigarette, and Marijuana Use

Tammy Chung Kevin H. Kim

University of Pittsburgh Medical Center University of Pittsburgh

Alison E. Hipwell and Stephanie D. Stepp

University of Pittsburgh Medical Center
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

Emerging research suggests that white youth are more likely to show continuity of alcohol use in the year
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after drinking onset, compared with black youth. Little is known, however, regarding racial differences
in year-to-year continuity of alcohol, cigarette, and marijuana use during adolescence, particularly among
females, who are at greater risk for certain substance-related harm than males. This study used latent
class/transition analysis to identify profiles of past year alcohol, cigarette, and marijuana use at ages
13–17 in a community sample of 1076 adolescent females (57% black, 43% white). Three profiles of past
year substance use were identified in separate analyses by race: “no use,” “alcohol only,” and “polydrug
use.” Although similar labels describe the profiles, the probability of endorsing use of a particular
substance for a given profile differed by race, precluding direct comparison. Latent transition analyses of
five annual waves covering ages 13–17 indicated that an intermittent pattern of use (e.g., use in one year,
but not the next) was relatively low at all ages among white girls, but among black girls, an intermittent
pattern of use began to decline at age 15. Among black girls, conduct problems at age 12 predicted
substance using profiles at age 13, whereas among white girls, intentions to use alcohol and cigarettes at
age 12 predicted substance using profiles at age 13. Racial differences in girls’ substance use profiles
suggest the potential utility of culturally tailored interventions that focus on differences in risk for
specific substances and relatively distinct early patterns of use.

Keywords: adolescent females, alcohol, cigarette, marijuana, race/ethnicity, conduct problems

Supplemental materials: http://dx.doi.org/10.1037/a0031173.supp

National survey data indicate racial/ethnic differences in ado-
lescent substance use, such that white adolescents report higher
rates of alcohol, cigarette, and marijuana use compared with black
youth (Johnston et al., 2010; Substance Abuse & Mental Health
Services Administration, 2011). In the context of these racial/
ethnic differences, there also has been a narrowing gender gap in
rates of substance use with females catching up to males in recent
years (Johnston et al., 2010). The increasing prevalence of sub-
stance use among adolescent females is alarming because females
This article was published Online First February 25, 2013.
Tammy Chung, Western Psychiatric Institute and Clinic, University of
Pittsburgh Medical Center; Kevin H. Kim, School of Education and Grad-
uate School of Business, University of Pittsburgh; Alison E. Hipwell and
Stephanie D. Stepp, Western Psychiatric Institute and Clinic, University of
Pittsburgh Medical Center.
This work was supported by National Institute of Drug Abuse grant R01
DA012237, National Institute of Mental Health grant R01 MH056630,
National Institute of Alcohol Abuse and Alcoholism grant K02 018195,
The Office of Juvenile Justice and Delinquency Prevention, the Federation
of Independent School Alumnae Foundation, and the Falk Fund.
Correspondence concerning this article should be addressed to Tammy
Chung, PhD, WPIC/Pittsburgh Adolescent Alcohol Research Center, 3811
O’Hara Street, Pittsburgh, PA 15213. E-mail: chungta@upmc.edu
1110
are at greater risk for certain types of substance-related harm
compared with males (Institute of Medicine, 2004; Nolen-
Hoeksema, 2004). Specifically, substance using females, com-
pared with males, may be at greater risk for dating violence (e.g.,
Foshee et al., 2001), risky sexual behavior and sexually transmitted
disease (e.g., Hutton et al., 2008), and accelerated progression to
nicotine dependence (DiFranza et al., 2002). Greater risk for harm
among females may be attributable, for example, to greater effects
of a substance at similar doses (e.g., alcohol), and contexts of use
(e.g., with a substance-using romantic partner), which may facil-
itate the occurrence of substance-related harm relative to males
(Nolen-Hoeksema, 2004). In the context of such risks, and the
need to understand racial/ethnic differences in patterns and pre-
dictors of substance use, this study examined age-to-age changes
in alcohol, cigarette, and marijuana use during adolescence in
white and black girls.
Prototypical profiles of adolescent substance use (e.g., “alcohol
only,” “alcohol and tobacco use”) have been identified in cross-
sectional data using latent class analysis (LCA) (e.g., Lanza &
Collins, 2002; Reboussin, Hubbard, & Ialongo, 2007; Dauber et
al., 2009; Lanza, Patrick, & Maggs, 2010; Cleveland et al., 2010).
LCA is a person-centered approach to identifying latent classes or
common profiles of substance use that reflect relatively distinct
subgroups (Collins & Lanza, 2010). When alcohol, cigarette, and
marijuana use have been used to derive substance use profiles in
 SUBSTANCE USE PROFILES
adolescents, 4 – 8 profiles have been identified, such as “no use,”
“alcohol only,” “cigarette only,” and “alcohol, cigarette, and mar-
ijuana use” (e.g., Lanza et al., 2010; Cleveland et al., 2010).
Differences across studies in the number and nature of the sub-
stance use profiles that have been identified may reflect, for
example, differences in sample age range, recruitment method, and
differences in the items (e.g., consumption of 5⫹ drinks per
occasion) and time frames used.
Some studies have characterized substance use profiles in spe-
cific race/ethnic groups using LCA (e.g., Hispanic youth:
Maldonado-Molina et al., 2007; black youth: Reboussin et al.,
2007). One cross-sectional study contrasted white and black ado-
lescent females (ages 13–19) on profiles based only on alcohol
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involvement (Dauber et al., 2009), and found four subtypes in
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white females (abstainers, experimenters, moderate drinkers,
heavy drinkers), but only three subtypes in black females (abstain-
ers, experimenters, problem drinkers). Among black females, the
“problem drinker” class represented a level of alcohol involvement
severity that was between the “moderate” and “heavy drinker”
subtypes identified for white females, a result that reflects the
overall lower level of alcohol severity among black females
(Dauber et al., 2009). The cross-sectional study by Dauber and
colleagues (2009) suggests racial differences in alcohol use pro-
files among adolescent females, but was limited in examining only
alcohol involvement, although concurrent use of other substances
(e.g., concurrent use of alcohol and tobacco), is relatively common
among youth (e.g., alcohol and tobacco: Orlando et al., 2005).
The longitudinal extension of LCA, latent transition analysis
(LTA; Collins & Lanza, 2010) can be used to estimate not only
continuity of substance use at adjacent time points, but has the
specific advantage of estimating “backward” transitions in use
(e.g., use of a substance in one year, and no use of that substance
in the following year), which may be common in early adoles-
cence. For example, a recent study focusing on alcohol use found
that black youth were less likely to drink in the year after initiation
of drinking compared with white youth, whereas white youth were
more likely to show continuity of alcohol use in the year after
drinking onset (Malone et al., 2012). Further, LTA indicated that
black adolescent girls were more likely to be in abstainer and
decreasing alcohol use classes at 1-year follow-up compared with
white girls (Dauber, Paulson, & Leiferman, 2011). Although the
LTA conducted by Dauber and colleagues (2011) identified im-
portant differences in alcohol severity between black and white
adolescent (ages 13–19) girls over 1-year follow-up, the study did
not address other commonly used substances (e.g., cigarettes,
marijuana), and did not provide information on age-to-age changes
in substance use during adolescence. Trajectory or growth curve
analyses also have been used to characterize race/ethnic differ-
ences in the development of substance use, with research suggest-
ing that white youth tend to show more steady escalation of
alcohol use compared with black youth (Flory et al., 2006). Tra-
jectory analyses, however, are more limited in capturing experi-
mental or intermittent (e.g., use of a substance in one year, but not
the next) patterns of use, relative to LTA.
The current study addresses limitations of existing LCA and
LTA studies by identifying prototypical substance use profiles
based not just on a single substance (cf. Dauber et al., 2009; 2011),
but on three substances commonly used by youth (i.e., alcohol,
cigarettes, marijuana), and conducting LTA on five annual waves
1111
of data (most LTA studies have used ⬍4 time points). Perhaps
most importantly, the current study provides a unique contribution
by examining change in substance use profile from age-to-age
during adolescence in a relatively large sample of black and white
female adolescents, permitting identification of differences by race
in age-related change points in emerging patterns of substance use.
LTA is well-suited to capturing intermittent patterns of use and
identifying the point of transition to a more persistent pattern of
use, relative to trajectory analyses. The current study’s age-to-age
estimation of transition probabilities can provide information to
inform the timing (i.e., age) and type (i.e., content addressing
specific substances) of prevention efforts that may be most effec-
tive for specific race/ethnic groups of adolescent girls.
Beyond identifying adolescent substance use profiles, and ex-
amining changes in use, predictors of the profiles and of transitions
between profiles over time warrant study as potential targets for
intervention. A social developmental framework (Hawkins, Cata-
lano, & Miller, 1992) proposes that individual (e.g., conduct prob-
lems, substance-related cognitions) and social (e.g., perceptions of
peer substance use) factors play key roles in influencing risk for
adolescent substance use. For example, prior analyses in the Pitts-
burgh Girls Study examined girls’ expectancies or beliefs regard-
ing the effects of substance use in relation to alcohol and cigarette
use (Hipwell et al., 2005; Chung et al., 2008; Chung et al., 2010),
and girls’ conduct problems in relation to early alcohol use (Loe-
ber et al., 2010). Importantly, among white girls in the Pittsburgh
Girls Study, conduct problems predicted alcohol use at ages 11–
13, but not at older ages (14 –15), whereas among black girls,
conduct problems predicted alcohol use at ages 13–14, but not
earlier (Loeber et al., 2010). These findings generally support
conduct problems as a robust predictor of adolescent substance use
(e.g., Brown et al., 2008; Windle et al., 2008), but also suggest
possible differences by race in the association between conduct
problems and substance use in girls that warrant further study.
In addition to examining conduct problems as a relatively robust
predictor of substance use, two cognitive factors, intention to
engage in substance use and perceived peer substance use, deserve
attention as predictors of substance use profiles and transition
probabilities. Intention to engage in a specific behavior, according
to the theory of planned behavior (Ajzen, 2012), can serve as a
proximal determinant of behavior. “Intention” reflects a composite
of an individual’s attitudes, outcome expectancies, and perceived
norms regarding the behavior (Ajzen, 2012). “Intention to use” a
substance has been associated concurrently and prospectively with
adolescent substance use (e.g., Andrews et al., 2008; Skenderian et
al., 2008; Maddahian, Newcomb, & Bentler, 1988; Hornik et al.,
2008). “Intention to use” has been associated with current level of
substance use among both white and black adolescents, however
the strength of the association varied by race/ethnicity and type of
substance (Maddahian et al., 1988), suggesting the importance of
examining race/ethnic differences in this association.
Perceived peer substance use also is a relatively robust predictor
of adolescent substance use (e.g., Curran, Stice, & Chassin, 1997),
and may independently (i.e., over and above intention to use and
conduct problems) predict a girl’s substance use status, and
changes in use over time. Some research suggests race/ethnic
differences in the importance of perceived peer use as a predictor
of adolescent substance use. For example, perception of friends’
cigarette smoking was a risk factor for an adolescent’s smoking
 1112 CHUNG, KIM, HIPWELL, AND STEPP
behavior, but the association was stronger among white, relative to
black, youth (Unger et al., 2001). Based on some research sug-
gesting race/ethnic differences in the importance of certain risk
factors as predictors of substance use (e.g., Wallace et al., 2009;
Ellickson & Morton, 1999), we examined differences by race in
the association between conduct problems, intention to use, and
peer use in relation to substance use profiles in black and white
adolescent girls.
This longitudinal study aimed to identify prototypical profiles
(latent classes) of past year alcohol, cigarette, and marijuana use
(e.g., “no use,” “alcohol use only”) across ages 13 through 17, and
to estimate transition probabilities among the profiles for adjacent
time points in black and white adolescent girls. Consistent with
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cross-sectional and longitudinal analyses characterizing race/eth-
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nic differences in adolescent substance use (e.g., Johnston et al.,
2010; Dauber et al., 2011; Flory et al., 2006; Orlando et al., 2005),
we hypothesized that white girls would be more likely than black
girls to be in substance using (vs. “no use”) profiles. We also
expected, based on the literature (e.g., Malone et al., 2012), that
white girls would show greater age-to-age continuity of substance
use (i.e., lower probability of “backward” transitions, e.g., from
use to no use classes) than black girls. Further, we tested the
hypothesis that intention to use, perceived peer substance use, and
conduct problems at age 12 would be more strongly associated
with substance use profile at age 13, and transition probabilities
over ages 13–17 among white, relative to black, girls (e.g., Wal-
lace et al., 2009). Identification of race/ethnic differences in risk
for and continuity of substance use in adolescence has potential
implications for refining culturally tailored interventions for youth.
Method
Participants
The Pittsburgh Girls Study (PGS; n ⫽ 2,451) is a population-
based urban sample of girls first assessed at ages 5– 8 (4 age
cohorts), who have been followed annually. PGS sample ascer-
tainment and methods have been detailed elsewhere (Hipwell et
al., 2002; Keenan et al., 2010). Briefly, PGS oversampled low
income neighborhoods, with 85% of eligible families completing
the first wave of data collection. The current analyses used the two
oldest of the four PGS age cohorts for whom data at ages 13–17
were available for analysis (at wave 1: age 7 n ⫽ 611; age 8 n ⫽
622; total n at wave 1 for the two cohorts ⫽ 1233), and excluded
the small number of girls who, according to the caregiver’s report,
were not identified as white or black (n ⫽ 70: n ⫽ 38 in age cohort
7 and n ⫽ 32 in age cohort 8), and who did not provide substance
use data at ages 13–17 (n ⫽ 87; n ⫽ 42 in age cohort 7 and n ⫽
45 in age cohort 8). Retention over follow-up was high: 88.7%
over ages 12–17 (data collection years 2005–2012). The analysis
sample included 1,076 girls (black n ⫽ 611, 56.8%; white n ⫽
465, 43.2%) who provided data on substance use for at least one
wave from ages 13–17. In the analysis sample, a minority (35.7%)
of families received public assistance at wave 1; lifetime substance
use before age 13 was 13.4% for alcohol (including sips and
tastes), 8.2% for cigarettes, and 2.6% for marijuana.
There were no statistically significant differences between par-
ticipants included in the analyses (n ⫽ 1076) and those who were
not (n ⫽ 157) on younger versus older cohort; receipt of public
assistance at wave 1; single parent household; caretaker education
ⱕ12 years versus ⬎12 years; or girls’ alcohol, cigarette, or mar-
ijuana use in each year through age 12. White girls were more
likely to be excluded from the analysis sample because of the
absence of substance use data at ages 13–17 than black girls (10%
vs. 5% excluded, respectively; ␹2[1] ⫽ 8.9, p ⬍ .01).
Procedure
Annual in-home computerized interviews were conducted with
the girl by highly trained research staff (Hipwell et al., 2002;
Keenan et al., 2010). Participants were compensated for their time.
All study procedures were approved by the University of Pitts-
burgh Institutional Review Board.
Measures
The Nicotine, Alcohol, and Drug Substance Use measure (Pan-
dina, Labouvie, & White, 1984) assessed past year use of any
alcohol (including sips and tastes), cigarettes, and marijuana at
ages 13–17 (each substance coded 1 ⫽ no, 2 ⫽ yes at each age).
Past year rates of substance use in PGS are generally similar to
rates reported for national survey data (cf. Johnston et al., 2010;
Substance Abuse & Mental Health Services Administration,
2011).
The following eight covariates were assessed at age 12. Receipt
of public assistance in the past year was coded 0 ⫽ no and 1 ⫽ yes.
Items assessing “intention to use” were asked separately for alco-
hol, cigarettes, and marijuana (“How likely is it that you would use
[substance] even once or twice in the next year?”) using the
following response categories: 1 ⫽ definitely not, 2 ⫽ probably
not, 3 ⫽ probably yes, 4 ⫽ definitely yes (Maddahian et al., 1988;
Ellickson & Morton, 1999; Hornik et al., 2008). Because of
skewed distribution, intention variables were coded 0 ⫽ definitely
not and 1 ⫽ probably not through definitely yes for each substance.
Peer substance use was assessed separately for alcohol, cigarettes,
and marijuana (“How many of your friends have used [sub-
stance]?”) using the following response categories: 0 ⫽ none, 1 ⫽
one peer, 2 ⫽ some, 3 ⫽ all (Curran et al., 1997; Johnston et al.,
2010). As a result of skewed distribution, peer use was coded 0 ⫽
none and 1 ⫽ one or more peers. Conduct problems (past year)
were assessed using girl report at age 12 on the Child Symptom
Inventory-Fourth Edition (Gadow & Sprafkin, 1994), which cov-
ers DSM–IV (American Psychiatric Association, 1994) symptoms
of conduct disorder rated on a 4-point scale (0 ⫽ never to 3 ⫽ very
often). As a result of skewed distribution of the summary score,
conduct problems were represented as a dichotomous variable
coded 0 ⫽ no past year problems and 1 ⫽ 1 or more conduct
problems.
Data Analysis
First, we used PROC LTA (version 1.1.7; Lanza et al., 2011) to
test the fit of 2–5 classes across the 5 time points (ages 13–17),
specifying invariance of item response probabilities (IRPs) for
each latent class over time, separately for black and white sub-
samples, per procedures outlined in Collins and Lanza (2010).
Preliminary analyses indicated that it was not feasible to include
substance use data at younger ages (ages 8 –12) in the model
 SUBSTANCE USE PROFILES
because of data sparseness. Examining the fit of a specific number
of latent classes simultaneously over 5 time points using LTA
allowed for efficient identification of a substance use profile,
which had the same meaning at each time point, in each sub-
sample. The longitudinal model estimated the following parame-
ters: latent class (profile) membership probabilities at Time 1, item
response probabilities (IRPs) for each class (i.e., the probability of
using alcohol, marijuana, and cigarettes), and transition probabil-
ities between latent classes for consecutive time points. PROC
LTA accommodates incomplete data using full information max-
imum likelihood estimation (Collins & Lanza, 2010). The best-
fitting model was determined by considering the likelihood ratio
G2 (which is ␹2 distributed; lower value indicates better fit),
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Bayesian Information Criterion (BIC; lower value indicates better
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fit), Akaike Information Criterion (AIC; lower value indicates
better fit), and the conceptual relevance of the latent classes
identified (Collins & Lanza, 2010). Among the fit indices, BIC
was preferred because it takes model complexity (i.e., the number
of parameters estimated) into account in determining the best
fitting model (Henson, Reise, & Kim, 2007).
Second, we tested the feasibility of using a multiple group
approach to directly compare black and white samples using the
best fitting LTA model in each group (i.e., 3-class LTA model).
Specifically, we compared a model in which IRPs were equal over
time but free across racial groups to a model in which IRPs were
equal over time and across racial groups. Results indicated a
significant difference in IRPs across race (⌬G2 ⫽ 292.03, df ⫽ 9,
p ⬍ .001), indicating that black and white subgroups differed in
substance use profiles. Thus, direct comparison of black and white
subsamples using LTA was not feasible, and separate analyses by
race were conducted.
Third, we included eight covariates assessed at age 12 in the
LTA model: receipt of public assistance; intention to engage in
alcohol, marijuana, and cigarette use in the next year (asked
separately for each substance); perceived peer use of alcohol,
marijuana, and cigarettes (asked separately for each substance);
and past year conduct problems. Proc LTA excludes cases with
missing covariate data, resulting in covariate analysis sample sizes
of 565 black girls and 433 white girls. There were no statistically
significant differences between cases that were included versus
excluded from the covariate analyses on receipt of public assis-
tance or alcohol, cigarettes, or marijuana use through age 12.
In the first covariate LTA model, the eight age 12 covariates
(entered simultaneously) were used to predict latent class mem-
bership at age 13. The second covariate LTA model built on the
first model by also using the significant predictors of profile
membership at age 13 as predictors of the four transitions. Nested
model comparison tested the significance of covariates as transi-
tion predictors.
Results
Prevalence of Substance Use and Covariates by Race
As expected, the prevalence of past year alcohol, cigarette, and
marijuana use increased with age in both subgroups (see Table 1).
With regard to differences by race, prevalence of alcohol and
cigarette use was higher among white girls than black girls at each
age as determined by ␹2 tests (at p ⬍ .01; see Table 1 for
1113
statistics), except for cigarette use at age 13, when there was no
significant difference by race (p ⫽ .08). Prevalence of marijuana
use was higher among black, compared with white, girls at ages
13, 14, and 16 (p ⬍ .05). With regard to covariates assessed at age
12, black girls were more likely than white girls to have received
public assistance; to report intention to use marijuana; to perceive
greater peer use of alcohol, marijuana, and cigarettes; and to report
one or more conduct problems compared with white girls (see
Table 1 for details).
Best Fitting LTA Model in Black and White
Subgroups
In the black subgroup, the likelihood ratio G2 indicated better fit
with each additional class; the 3-class LTA had the lowest BIC, but
the 4-class LTA had the lowest AIC (see Table 2). The 3-class
model was selected based on BIC, which favors model parsimony.
The 3-class model included a “no use” class (IRPs ⫽ .00 –.02); a
class with some likelihood of alcohol use (IRP ⫽ .38; marijuana
IRP ⫽ .22, cigarette IRP ⫽ .14); and a “polydrug use” class
representing alcohol (IRP ⫽ .73), marijuana (IRP ⫽ .89), and
cigarette (IRP ⫽ .59) use. The label “polydrug use” is used to
represent girls who generally reported some combination (i.e.,
usually 2 or more) of alcohol, cigarette, and marijuana use in the
past year; IRPs for the polydrug use profile suggest relatively high
likelihood of alcohol and marijuana use for this profile. Note that
the IRPs only indicate the likelihood of endorsing past year use of
a specific substance, and that, in particular, the “polydrug use”
profile represents cases with heterogeneous combinations of past
year substance use (e.g., use of all 3 substances in the past year;
only alcohol and tobacco; etc.).
In the white subgroup, the likelihood ratio G2 indicated better fit
with each additional class; the 3-class LTA had the lowest BIC, but
the 4-class LTA had the lowest AIC (see Table 2). As above, the
3-class model was selected based on BIC and model parsimony.
The 3-class model included a “no use” class (IRPs ⫽ .00 –.07); an
alcohol use class (alcohol IRP ⫽ .83, marijuana IRP ⫽ .10,
cigarette IRP ⫽ .10); and a “polydrug use” class representing use
of alcohol (IRP ⫽ .84), cigarettes (IRP ⫽ .89), and marijuana
(IRP ⫽ .60). As above, the “polydrug use” label is used to
represent girls who typically reported a combination (i.e., usually
2 or more) of alcohol, cigarettes, and marijuana use in the past
year.
Prevalence of Substance Use Profiles and Transition
Probabilities: Analyses by Race
Although a 3-class model was selected in both black and white
subsamples, and the identified profiles have similar labels (i.e., no
use, alcohol use, polydrug use), we did not test for differences by
race in profile prevalence because the IRPs for the substance use
profiles differed by race (described above in step two of the
approach to data analysis). Descriptively, however, at age 13, the
most common profile was “no use” in both groups (77% and 76%
in black and white girls, respectively; see Table 3). Estimated
prevalence of the “alcohol use” and “polydrug use” profiles gen-
erally increased with age in each subsample (see Table 3). In both
subsamples, the largest reduction in the “no use” profile occurred
between ages 13 and 14. Among black girls, estimated prevalence
 1114 CHUNG, KIM, HIPWELL, AND STEPP

Table 1
Sample Descriptive Statistics

Total sample Black girls White girls Black vs white girls

Past year use n % n % n % ␹2(1)

Alcohol
Age 13 196 18.6 80 13.4 116 25.5 24.2ⴱⴱ
Age 14 264 25.8 104 17.8 160 36.5 44.8ⴱⴱ
Age 15 301 29.6 130 22.4 171 39.3 33.3ⴱⴱ
Age 16 353 35.4 150 26.2 203 47.6 48.0ⴱⴱ
Age 17 407 41.4 177 30.9 230 56.0 61.1ⴱⴱ
Cigarette
Age 13 66 6.3 34 5.7 32 7.0 0.5
Age 14 111 10.8 49 8.4 62 14.2 8.1ⴱⴱ
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Age 15 150 14.7 62 10.7 88 20.2 17.1ⴱⴱ

14.2ⴱⴱ
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Age 16 191 19.2 86 15.0 105 24.7

Age 17 222 22.6 102 17.8 120 29.2 17.1ⴱⴱ
Marijuana
Age 13 49 4.7 36 6.0 13 2.9 4.9ⴱ
Age 14 126 12.3 84 14.4 42 9.6 4.9ⴱ
Age 15 180 17.7 109 18.8 71 16.3 0.9
Age 16 221 22.2 142 24.8 79 18.6 5.1ⴱ
Age 17 236 24.0 143 25.0 93 22.6 0.6
Received Pub Assist 377 35.7 309 51.6 68 14.8 152.7ⴱⴱ
Alcohol intent 139 13.2 83 13.9 56 12.4 0.5
Marijuana intent 81 7.7 66 11.0 15 3.3 21.5ⴱⴱ
Cigarette intent 73 6.9 47 7.8 26 5.7 1.8
Peer alcohol use 215 21.1 149 25.9 66 14.9 18.1ⴱⴱ
Peer marijuana use 147 14.4 118 20.5 29 6.6 39.1ⴱⴱ
Peer cigarette use 221 21.7 142 24.7 79 17.8 6.9ⴱⴱ
Conduct problems 150 14.2 121 20.2 29 6.4 40.4ⴱⴱ
Note. Received Pub Assist ⫽ Received Public Assistance in the past year. Intention to use (dichotomous coding) represents the proportion endorsing:
“probably not,” “probably yes,” or “definitely yes” combined versus “definitely not.” Peer use (dichotomous coding) represents the proportion reporting
no peer use vs any peer use. Conduct problems represents the proportion endorsing any conduct problem. Sample size at age 13: Total sample n ⫽ 1076,
Black girls n ⫽ 611, White girls n ⫽ 465. Total sample size ranges from 1019 –1057 due to missing data; Black sample size ranges from 576 – 600; White
sample size ranges from 442– 458.
ⴱ
p ⬍ .05, ⴱⴱ p ⬍ .01.

of the “alcohol use” profile was greater than the “polydrug use”
profile at all ages (age 13: ␹2 [1] ⫽ 66.1, p ⬍ .001; age 14: ␹2 [1] ⫽
54.3, p ⬍ .001; age 15: ␹2 [1] ⫽ 73.8, p ⬍ .001; age 16: ␹2 [1] ⫽ 35.4,
p ⬍ .001; age 17: ␹2 [1] ⫽ 70.8, p ⬍ .001). Among white girls,
estimated prevalence of the “alcohol use” profile was greater than the
“polydrug use” profile only at ages 13 and 14 (age 13: ␹2 [1] ⫽ 37.3,
p ⬍ .001; age 14: ␹2 [1] ⫽ 17.2, p ⬍ .001). Whereas the prevalence
of the “alcohol use” profile was higher than “polydrug use” at all ages
in black girls, this difference was observed only at early ages (13–14)
among white girls, possibly suggesting white girls’ greater involve-
ment with more than one substance (e.g., alcohol and cigarettes) with
age.
Table 4 presents transition probabilities for adjacent time points
(e.g., probability of transitioning to “alcohol use” at age 14 from

Table 2
Comparison of Latent Transition Models, Ages 13–17 (5 Time Points)

Number of classes Likelihood-ratio G2 Degrees of freedom AIC BIC

Black girls (n ⫽ 611) 1

2 1641.04 32,752 1671.04 1737.26

3 1501.27 32,732 1571.27 1725.79
4 1398.75 32,704 1524.75 1804.90
5 No convergence — — —
White girls (n ⫽ 465)1
2 1246.98 32,752 1276.98 1339.11
3 985.42 32,732 1055.42 1200.39
4 883.74 32,704 1009.74 1270.68
5 814.54 32,668 1012.54 1422.60
Note. AIC ⫽ Akaike Information Criterion; BIC ⫽ Bayesian Information Criterion. Bolded values indicate
best fitting model according to a certain index of model fit.
1
Item-response probabilities are invariant across time.
 SUBSTANCE USE PROFILES 1115

Table 3 problems were not a significant predictor of transition probabilities

Estimated Substance Use Profile Prevalence at Each Age among black girls (⌬G2 ⫽ 30.26, df ⫽ 24, p ⫽ .18).
by Race For white girls, intention to use alcohol (p ⫽ .004) and intention
to use cigarettes (p ⫽ .0004) at age 12 predicted age 13 substance
No use Alcohol use Polydrug use use profile (see Table 6). White girls who reported intention to use
Black girls alcohol had higher odds of membership in the “alcohol use”
Age 13 .77 .19 .04 (OR ⫽ 3.56) and “polydrug use” (OR ⫽ 3.49) profiles at age 13,
Age 14 .66 .25 .09 relative to the “no use” profile. Further, white girls who reported
Age 15 .53 .34 .13 intention to use cigarettes at age 12 had higher odds of member-
Age 16 .48 .33 .18
Age 17 .41 .40 .18 ship in the “polydrug use” profile (OR ⫽ 13.23) relative to the “no
White girls use” profile at age 13. With regard to prediction of transitions
Age 13 .76 .18 .05 between profiles over time, intentions to use alcohol and cigarettes
Age 14 .61 .25 .14 were not significant predictors of transitions among white girls
Age 15 .56 .22 .22
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(⌬G2 ⫽ 40.78, df ⫽ 36, p ⫽ .27).

Age 16 .46 .28 .26
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Age 17 .38 .32 .29

Note. Black subsample n ⫽ 611; White subsample n ⫽ 465. The
“Polydrug use” class generally represents some combination (i.e., 2 or
more) of alcohol, cigarettes, and marijuana use in the past year.
substance use status at age 13), estimated separately by race.
Values along the diagonal indicate stability of substance use pro-
file at two consecutive time points (e.g., black girls in the “no use”
profile at age 13 have probability of .82 for staying in that profile
at age 14). Values in off-diagonal cells reflect the probability of
transitioning to a different profile one year later. Of particular
interest are “backward” transitions (i.e., intermittent use) that
reflect use of a substance in one year, and no use of that substance
in the following year. “Forward” transitions involve moving from
no use to use of a substance, or an increase in the number of
substances used in the following year.
Among black girls, from age 13 to 14, although there were more
“forward” (sum of “forward” transitions ⫽ .43) than “backward”
transitions (sum of “backward” transitions ⫽ .34), the “backward”
transitions suggest intermittent or experimental use in a subset of
girls. From age 14 to 15, “backward” transitions among black girls
mainly involved moving from the “polydrug use” profile at age 14
to the “alcohol use” profile at age 15 (transition probability ⫽ .23).
There was a decline in “backward” transitions starting at age 15,
which occurred in the context of relatively high probability (.83–
.99) of remaining in a given substance using profile.
Among white girls, the estimated probability of “backward”
transitions was relatively low at all ages (sum of “backward”
transitions across ages 13–17 ⫽ .04 –.13). White girls estimated to
be in the “polydrug use” profile had high likelihood of remaining
in that profile for each transition (probability of remaining in the
“polydrug use” profile ⫽ .93–1.00), suggesting persistence of use.
Including Covariates in the LTA Model for Each
Racial Group
The eight age 12 covariates were entered simultaneously as
predictors of the age 13 substance use profile in LTA analyses
conducted separately in black and white subsamples. Among black
girls, conduct problems at age 12 predicted age 13 substance use
profile (p ⫽ .0004; Table 5), such that black girls who reported any
conduct problem had higher odds of membership in “alcohol use”
(Odds ratio [OR] ⫽ 2.83) and “polydrug use” (OR ⫽ 5.50) profiles
at age 13, relative to the “no use” profile. However, conduct
Results Summary
Three substance use profiles, representing “no use,” “alcohol
use,” and “polydrug use” (i.e., typically some combination of past
year alcohol, marijuana, and tobacco use), were identified for
black and white girls. However, the 3 profiles are not directly
comparable across race, because of differences in item response
probabilities for the profiles. In both subsamples, the proportion in
the “no use” profile showed the greatest decline between ages 13
and 14. As hypothesized, among white girls, an intermittent pattern
of use was infrequent at all ages (i.e., 13–17), suggesting persis-
tence of use once initiated, whereas among some black girls, an
intermittent pattern of use at ages 13–14 began to decline at age 15.
In partial support of hypotheses regarding differences by race in
the importance of risk factors as predictors of substance use
profiles and transitions, conduct problems at age 12 were associ-
ated with substance use profiles among black girls, whereas inten-
tion to use alcohol and cigarettes at age 12 predicted membership
in substance using classes among white girls.
Discussion
This study provides a unique contribution to the literature by
identifying substance use profiles based on simultaneous consid-
eration of alcohol, marijuana, and cigarette use; and examining
age-to-age change in substance use profile using annual data
collected at ages 13–17, separately for black and white girls.
Differences by race in substance use profiles, longitudinal pattern
of use, and risk factors were identified. Although 3 substance use
profiles were identified for both white and black girls, differences
in the prevalence of certain substances (e.g., greater alcohol use
among white than black girls) contributed to differences by race in
the profiles identified. Analysis of age-to-age data over five annual
waves indicated a decline in the “no use” profile between ages
13–14, which may mark an important turning point for initiation of
substance use among white and black girls (cf. Faden, 2006;
Johnston et al., 2010). Further, although white girls tended to show
stability of use from year to year, some black girls showed an early
intermittent pattern of use at ages 13–14, which declined in prev-
alence after age 15. Racial differences in substance use profiles
were related to distinct risk factors (cf. Bachman et al., 1991),
suggesting the potential utility of tailored interventions.
The substance use profiles identified in this study are largely
consistent with profiles reported in the literature (e.g., Lanza et
 1116 CHUNG, KIM, HIPWELL, AND STEPP

Table 4
Probabilities of Transitioning Between Substance Use Profiles at Ages 13–17 by Race

No use Alc use Polydrug use Forward transitions Backward transitions

Black girls
Age 14
No use: Age 13 .82 .16 .02 .18
Alc use: Age 13 .12 .63 .25 .25 .12
Polydrug: Age 13 .00 .22 .78 .22
Age 15
No use: Age 14 .79 .19 .02 .21
Alc use: Age 14 .05 .76 .19 .19 .05
Polydrug: Age 14 .00 .23 .76 .23
Age 16
No use: Age 15 .90 .10 .00 .10
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Alc use: Age 15 .00 .83 .16 .16 .00

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Polydrug: Age 15 .01 .00 .99 .01

Age 17
No use: Age 16 .82 .18 .00 .18
Alc use: Age 16 .01 .88 .11 .11 .01
Polydrug: Age 16 .05 .14 .81 .19
White girls
Age 14
No use: Age 13 .79 .13 .08 .21
Alc use: Age 13 .04 .82 .14 .14 .04
Polydrug: Age 13 .00 .00 1.00 .00
Age 15
No use: Age 14 .86 .09 .04 .13
Alc use: Age 14 .13 .65 .21 .21 .13
Polydrug: Age 14 .00 .00 1.00 .00
Age 16
No use: Age 15 .80 .14 .06 .20
Alc use: Age 15 .02 .88 .11 .11 .02
Polydrug: Age 15 .03 .04 .93 .07
Age 17
No use: Age 16 .75 .19 .06 .25
Alc use: Age 16 .12 .85 .03 .03 .12
Polydrug: Age 16 .01 .00 .99 .01
Note. Black (n ⫽ 611) and White (n ⫽ 465) groups were analyzed separately. Invariance of item response
probabilities across time was specified in the LTA model for each race. Alc ⫽ alcohol. The “Polydrug use” class
generally represents some combination (i.e., 2 or more) of alcohol, cigarettes, and marijuana use in the past year.
Bold font indicates membership in the same substance use profile at consecutive ages (e.g., ages 13 and 14);
values representing stability (i.e., probability of staying in the same profile at consecutive ages) are on the
diagonal. For example, among Black girls, the probability of staying in the “No use” profile at ages 13 and 14
is .82, and at ages 14 and 15 is .79; the probability of staying in the “Alcohol Use” profile at ages 13 and 14
is .63, and at ages 14 and 15 is .76. “Forward transitions” refer to moving from a profile representing less
substance involvement to a profile representing more substance involvement (e.g., transition from “no use” to
“alcohol use”). Cells in the “Forward transitions” column represent the sum of the forward transition probabil-
ities for a given row. As an example, for transitions between ages 13 and 14, forward transitions include moving
from “no use” at age 13 to “alcohol use” at age 14 (transition probability ⫽ .16) and “polydrug use” classes
(transition probability ⫽ .02) for a sum of .18 forward transitions for the “no use” class at age 13. In addition,
the forward transition from “alcohol use” at age 13 to the “polydrug use” class at age 14 was estimated to be
.25. “Backward transitions” refer to moving from a profile representing greater substance involvement to a
profile representing less substance involvement (e.g., transition from “alcohol use” to “no use”). Cells in the
“Backward transitions” column represent the sum of the backward transition probabilities for a given row. As
an example, for transitions between ages 13 and 14, backward transitions include moving from “alc use” at age
13 to “no use” at age 14 (transition probability ⫽ .12). In addition, the backward transition from “polydrug use”
at age 13 to “alcohol use” class at age 14 was estimated to be .22 (the estimate for backward transition from age
13 “polydrug use” to “no use” at age 14 was 0).

al., 2010; Cleveland et al., 2010), but also involve certain
differences. For example, no “cigarette use” only profile (e.g.,
Cleveland et al., 2010) was identified in the current analyses.
When studies have identified a “cigarette use” only profile, it
has typically represented only a minority of the sample (e.g.,
8% in Cleveland et al., 2010; 5% in Lanza et al., 2010). Some
research also suggests that use of only alcohol is more common
than reporting only cigarette use, because most adolescent
cigarette users also consume alcohol (Orlando et al., 2005). In
addition, the current study estimated substance use profiles over
a five-year period that covered an active shift from a majority
of nonusers to an increasing minority of nonusers with age. The
lower base rates of substance use at younger ages, and the need
to constrain item response probabilities for each of the three
 SUBSTANCE USE PROFILES 1117

Table 5
Latent Transition Analysis Model With Covariates – Black Girls: Significance Test for
Covariates (Simultaneous Entry) as Predictors of Age 13 (Time 1) Profile

Covariate Change in 2ⴱlog-likelihood Degrees of freedom p value

Public assistance 0.00 2 Not significant

Alcohol intention 2.02 2 0.36
Marijuana intention 0.00 2 Not significant
Cigarette intention 0.00 2 Not significant
Peer alcohol use 0.00 2 Not significant
Peer marijuana use 0.00 2 Not significant
Peer cigarette use 0.00 2 Not significant
Conduct problems 15.78 2 0.0004

Beta and odds ratios for age 13 (time 1) profile membership

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No use Alcohol use Polydrug use

Intercept
␤ 0s Reference group ⫺2.42 ⫺5.86
Odds Reference group 0.09 0.00
Public assistance
␤1s Reference group ⫺0.19 0.26
Odds ratios Reference group 0.82 1.30
Alcohol intention
␤2s Reference group 0.78 ⫺1.04
Odds ratios Reference group 2.19 0.35
Marijuana intention
␤3s Reference group 0.58 1.21
Odds ratios Reference group 1.79 3.36
Cigarette intention
␤4s Reference group 0.20 0.01
Odds ratios Reference group 1.22 1.01
Peer alcohol use
␤5s Reference group 0.36 0.20
Odds ratios Reference group 1.44 1.22
Peer marijuana use
␤6s Reference group 0.06 2.41
Odds ratios Reference group 1.07 11.12
Peer cigarette use
␤7s Reference group 0.41 ⫺0.33
Odds ratios Reference group 1.50 0.72
Conduct problems
␤8s Reference group 1.04 1.70
Odds ratios Reference group 2.83 5.50
Note. n ⫽ 565. Log-likelihood for overall model: ⫺2758.46. The top part of the table indicates the statistical
significance of each covariate (assessed at age 12). Covariates were entered simultaneously as predictors of age
13 substance use profile. The bottom part of the table reports betas and odds ratios for each covariate. Public
Assistance: 0 ⫽ No, 1 ⫽ Yes. Intention to use: 0 ⫽ Definitely No, 1 ⫽ Probably No through Definitely Yes. Peer
Use: 0 ⫽ None, 1 ⫽ One or more. Conduct Problems: 0 ⫽ none, 1 ⫽ 1 or more.

profiles to be equal across time, would tend to reduce the
number of profiles identified. Nevertheless, a unique contribu-
tion of the current analyses is the identification, by race, of
prototypical substance use profiles representing past year alco-
hol, cigarette, and marijuana use at each age, for ages 13 to 17.
An important point in interpreting the profiles identified in this
study is that because the profiles were identified based on past year
use of substance (rather than frequency of use), individuals esti-
mated to be in the “alcohol use” profile could differ in past year
frequency and quantity per occasion of alcohol use, and individ-
uals estimated to be in the “polydrug use” profile also might differ
in the frequency and usual quantity per occasion of past year use
of a given substance. Because of relatively low rates of use at early
ages, we focused on analysis of “use” versus “no use” in the past
year. Within-profile heterogeneity may be lower at younger ages,
when rates of substance use are relatively low, but would likely
increase with age as some girls show escalation in the use of
certain substances over time.
The substance use profiles identified in this study necessarily
differ from those identified by Dauber and colleagues (2009, 2011:
4 alcohol subtypes in white females and 3 alcohol subtypes in
black females) because work by Dauber and colleagues focused
only on alcohol involvement, and not other substances (i.e., mar-
ijuana, cigarettes), as in the current study. In addition, Dauber and
colleagues (2011) reported on 1-year follow-up of a sample of 13-
to 19-year-old females, whereas the current analyses permitted
analysis of age-to-age transitions in substance use profiles over
five annual waves of data collection. Importantly, however,
Dauber and colleagues were able to distinguish nonproblem and
problem drinkers in their analyses, a distinction that was not
 1118 CHUNG, KIM, HIPWELL, AND STEPP

Table 6
Latent Transition Analysis Model With Covariates – White Girls: Significance Test for
Covariates (Simultaneous Entry) as Predictors of Age 13 (Time 1) Profile

Covariate Change in 2ⴱlog-likelihood Degrees of freedom p value

Public assistance 3.47 2 0.18

Alcohol intention 11.06 2 0.004
Marijuana intention 0.00 2 Not significant
Cigarette intention 15.77 2 0.0004
Peer alcohol use 0.00 2 Not significant
Peer marijuana use 1.56 2 0.46
Peer cigarette use 0.00 2 Not significant
Conduct problems 0.00 2 Not significant

Beta and odds ratios for age 13 (time 1) profile membership

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No use Alcohol use Polydrug use

Intercept
␤ 0s Reference group ⫺1.74 ⫺4.40
Odds Reference group 0.17 0.01
Public assistance
␤1s Reference group ⫺0.52 1.23
Odds ratios Reference group 0.59 3.43
Alcohol intention
␤2s Reference group 1.27 1.25
Odds ratios Reference group 3.56 3.49
Marijuana intention
␤3s Reference group ⫺0.62 0.05
Odds ratios Reference group 0.54 1.05
Cigarette intention
␤4s Reference group 0.16 2.58
Odds ratios Reference group 1.17 13.23
Peer alcohol use
␤5s Reference group 0.29 ⫺0.13
Odds ratios Reference group 1.33 0.88
Peer marijuana use
␤6s Reference group ⫺0.05 1.68
Odds ratios Reference group 0.95 5.34
Peer cigarette use
␤7s Reference group 0.19 ⫺0.22
Odds ratios Reference group 1.21 0.80
Conduct problems
␤8s Reference group ⫺0.62 0.47
Odds ratios Reference group 0.54 1.59
Note. n ⫽ 433. Log-likelihood for overall model: ⫺2166.90. The top part of the table indicates the statistical
significance of each covariate (assessed at age 12). Covariates were entered simultaneously as predictors of age
13 substance use profile. The bottom part of the table reports betas and odds ratios for each covariate. Public
Assistance: 0 ⫽ No, 1 ⫽ Yes. Intention to use: 0 ⫽ Definitely No, 1 ⫽ Probably No through Definitely Yes. Peer
Use: 0 ⫽ None, 1 ⫽ One or more. Conduct Problems: 0 ⫽ none, 1 ⫽ 1 or more.

addressed here due to relatively low rates of substance use at early
ages (and correspondingly low prevalence of substance-related
problems at early ages).
It was not possible to directly compare the racial subgroups on
prevalence of the substance using profiles and transition probabil-
ities because there were differences by race in the IRPs for the
profiles. These differences in IRPs reflect the generally higher
prevalence of alcohol and cigarette use among white girls, com-
pared with black girls. Likewise, when other studies have con-
ducted separate analyses by race, for example, when examining
alcohol involvement subtypes using LCA (e.g., Dauber et al.,
2011) or alcohol use trajectories (e.g., Flory et al., 2006), results
have generally reflected the lower severity of alcohol use among
black youth. Racial differences in the substance use profiles sug-
gest that prevention efforts might be tailored to the substances
most commonly endorsed by a subgroup at a given age.
A novel feature of the current study involved examining specific
ages at which certain types of transitions (e.g., backward transi-
tions, continuity of use) were most likely among adolescent fe-
males. The finding that black girls showed intermittent substance
use in early adolescence (ages 13–14) is in accord with research
indicating lower persistence of alcohol use among black youth
(e.g., Malone et al., 2012; Dauber et al., 2011). The current study
adds to the existing literature by simultaneously examining the use
of cigarettes and marijuana, in tandem with alcohol. The person-
centered approach to analysis provided by LTA also suggests that
despite a steady increase in the prevalence of these substances with
age, that among black girls, the increase in prevalence of use at
 SUBSTANCE USE PROFILES
younger ages is not necessarily attributable to the same subset of
girls reporting use of a substance from year to year. Further, the
higher rate of intermittent use among black girls at early ages may
reflect early experimental or opportunistic episodes of use. In
contrast to the pattern observed among black girls, white girls were
more likely to report substance use in consecutive years following
onset of use, highlighting the importance of early intervention,
particularly among white girls, to halt continuation of use.
The generally lower prevalence of alcohol and cigarette use, and
intermittent, rather than continuous, pattern of substance use at
early ages (13–14) among black girls occurred, contrary to expec-
tation, in the context of their greater apparent risk for substance
use. Specifically, black girls were more likely than white girls to
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report risk factors at age 12 such as receipt of public assistance,
This document is copyrighted by the American Psychological Association or one of its allied publishers.
peer use, and conduct problems. As a possible explanation for this
apparent discrepancy, some research suggests that protective fac-
tors (e.g., parental monitoring) play an important role in buffering
risk for substance use (Bachman et al., 1991), particularly among
black urban youth (Griffin et al., 2000). Among the risk factors
examined, only conduct problems at age 12 predicted substance
use profile at age 13 among black girls, suggesting that conduct
problems might serve as an efficient screen to identify at-risk girls
for early intervention (cf. Loeber et al., 2010). In addition, the
finding that black girls reported greater intention to use marijuana
at age 12 than white girls, and the higher early prevalence of
marijuana use among black girls at ages 13–14, suggests that
tailored intervention content for this subgroup might address not
only reductions in conduct problems, but also cognitive factors
such as intention to use marijuana (cf., intervention to address
intention to use steroids: MacKinnon et al., 2001).
Among white girls, intention to use alcohol and cigarettes at age
12 predicted substance using profiles at age 13, suggesting that this
cognitive factor plays an early important role, relative to conduct
problems and peer use, as a predictor of substance use in this
subgroup. Since intention to use is determined by a girls’ attitudes
toward use and users of the substance, peer norms regarding use,
and perceived control to abstain from use (Ajzen, 2012), interven-
tion components could target these areas. For example, tailored
intervention, based on a needs assessment, could provide correc-
tive normative data on peer use and attitudes toward use, discus-
sion of the pros and cons of engaging in use in order to promote
abstinence, and facilitation and support of alternative healthy be-
haviors (cf. MacKinnon et al., 2001).
Study limitations warrant comment. Generalizability of results
to other race/ethnic groups, males, and younger and older ages is
limited. White, compared with black, girls were more likely to be
excluded from the analysis sample due to the absence of substance
use data at ages 13–17; however, participants who were included
versus excluded from the analysis sample did not differ on various
indicators of socioeconomic status (e.g., receipt of public assis-
tance) or on use of alcohol, marijuana, or tobacco through age 12.
Further, generalizability is limited because of regional and national
variations in social, regulatory, and legal factors influencing ado-
lescent substance involvement (e.g., attitudes toward use, avail-
ability). PROC LTA did not permit inclusion of sample weights in
the analyses, which limits the generalizability of results. Inclusion
of sample weights in similar analyses is a future direction for
research. Analyses did not examine temporal sequencing of the
initiation of each substance, and did not examine frequency of use
1119
in the past year or the occurrence of substance-related problems
because of low rates of past year use at young ages. The alcohol
use item included “sips and tastes,” which is a relatively low
threshold to determine whether alcohol use occurred. In addition,
substance-related problems and a wider range of substances were
not included in the analyses because of low base rates for these
types of items during the age range covered. Only selected risk
factors were examined, and analyses did not include consideration
of protective factors (e.g., parental supervision), which might
influence adolescent substance use. Self-reported substance use
data may have limitations. However, procedures were used to
maximize validity of self-report (e.g., assurance of confidential-
ity).
Study findings on racial differences in substance use profiles
and patterns of early use have public health implications with
regard to understanding the emergence of substance-related health
disparities in females. Although white girls were more likely to
report alcohol and cigarette use than black girls at ages 13–17, it
appears that there were fewer racial differences in prevalence of
marijuana use during the study time period. Prevention efforts may
have maximal effect when tailored to specific substances that are
most salient to certain subgroups of youth at specific ages. Further,
study findings, which indicate that ages 13–14 represent an im-
portant change point in risk for transition from a “no use” to
substance using profile in both white and black girls, has impli-
cations for informing the optimal timing of prevention efforts.
Differences by race in the relative importance of risk factors that
predict substance use profile also suggest the potential utility of
tailored interventions which target risk factors that are most
strongly associated with substance use in specific subgroups to
maximize effectiveness.
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Received April 5, 2012
Revision received November 2, 2012
Accepted November 12, 2012 䡲